iOnco
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This information is for educational purposes only. Off-label drug use carries risks. Always consult a qualified physician before using any drug outside its approved indication.

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LDN (Low Dose Naltrexone)

Naltrexone Hydrochloride (low dose)

Brand names: ReVia, Vivitrol (standard dose — must be compounded at low dose)

Opioid AntagonistImmune Modulatormoderate evidenceActive Clinical Trials

ORIGINALLY APPROVED FOR

Opioid/Alcohol Addiction (at standard 50 mg dose)

At doses of 1.5–4.5 mg (vs. the standard 50 mg), naltrexone transiently blocks opioid receptors for a few hours each night, causing a rebound overproduction of endogenous opioids (endorphins and met-enkephalin). This pulsed OGF (opioid growth factor) surge modulates the immune system profoundly — boosting NK cell activity, IL-12, and anti-tumour surveillance. Clinical evidence is growing for several cancers, with strongest data in pancreatic cancer and multiple myeloma.

Molecular Pathways Targeted

OGF-OGFrTLR4MicrogliaNK Cell ActivationIL-12

Mechanism of Action in Cancer

Transient nightly OGF receptor blockade → rebound upregulation of endogenous opioid growth factor → inhibits cell proliferation. Also reduces TLR4 microglial activation (anti-inflammatory) and boosts NK cell cytotoxicity against tumour cells.

Cancers Studied

PancreaticMultiple MyelomaOvarianBreastColorectalLymphomaGlioblastoma

Typical Off-Label Dosing

1.5–4.5 mg taken at bedtime (9–11 PM), typically as a compounded capsule or liquid. Must NOT be combined with opioid medications. Start at 1.5 mg and increase by 0.5 mg every 2 weeks.

* Dosing information from research literature only. Not a prescription. Requires physician supervision.

Cautions & Drug Interactions

  • MUST NOT be used with opioid pain medications — will precipitate withdrawal
  • Must be compounded — standard tablets are 50 mg and cannot be split accurately
  • Vivid dreams or insomnia in first 2–4 weeks — often resolves
  • May interfere with immunosuppressants
  • Avoid in autoimmune conditions on biologic therapy without specialist review
  • Not FDA-approved for cancer — off-label use only
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